In the new millennium, the concepts of oral health and systemic disease are growing and changing. There is no longer doubt that poor oral health has a significant, negative impact on general health and that reducing inflammation is essential to periodontal therapy. Infection and inflammation in the mouth have been linked to a number of systemic diseases, including diabetes, heart disease, stroke, and preterm, low–birth weight babies. This periodontal-systemic link works both ways and these systemic diseases also affect periodontal health. The most important factors determining a successful outcome of periodontal therapy in a medically compromised patient are plaque control and frequency of professional care. A supportive periodontal maintenance program should be initiated so that gingival inflammation can be detected and managed quickly. A team approach and interdisciplinary care from the periodontist, general dentist, and physician are necessary for the patient’s overall well-being.
This presentation will discuss the ways in which this inflammation link affects the ways we treat and maintain our medically compromised periodontal patients. We will discuss the role of patient medical histories, diagnostic markers, and risk assessment. In addition, the role of drugs, both anti-inflammatory and antimicrobial, and how they should be used in treatment and maintenance of patients.

Louis F. Rose, DDS, MD, is clinical professor of periodontics at the University of Pennsylvania School of Dental Medicine and adjunct professor of Periodontics at New York University. He is also professor of medicine and surgery at the Drexel University College of Medicine. He is a diplomate and director of the American Board of Periodontology and is on the editorial board of several peer-reviewed journals. He is editor-in-chief of Compendium of Continuing Education in Dentistry. He maintains a private practice in Philadelphia limited to periodontics and implant dentistry. Dr Rose is a nationally and internationally invited lecturer on periodontics, implant dentistry, and medicine and has published extensively on these subjects. This includes the textbooks Internal Medicine for Dentistry (Mosby, 1983), Periodontal Medicine (Decker, 2000), and Periodontics: Medicine, Surgery and Implants (Mosby, 2004). In addition, Dr Rose has co-authored articles about the connection between periodontal disease and diabetes.